Mental Health
An Overview
The Victorian Era represented a period in flux for mental health, or “madness” and “lunacy” as it was referred to at the time. Mental health was largely misunderstood, however, the period witnessed a change in terms of dealing with those with mental health issues. The beginning of the period was marked by the concept of dealing with patients. Restraint was used pervasively, with shackles, straight-jackets, muffs, etc. employed to control and “protect” asylum inmates and staff. Treatments such as hydropathy and electrotherapy were also used, with limited recorded success. Both of these treatments represented popular pseudoscientific claims at the time which touted the multifaceted benefits of both water and electricity treatments. These were employed to many different ailments and were therefore, not specific to the treatment of mental health. However, the Victorian era saw the move away from mechanical restraint towards a moral treatment of mental health. To strengthen the moral health of asylum inmates, pioneering doctors Robert Gardiner Hill and John Conolly advocated for strict work to discipline the mind and tire the body. This treatment proved unsuccessful later on, particularly as a result of growing populations and overcrowdedness the late 19th century would experience. As such, the end of the 19th century witnessed another change in the treatment of madness; sedation. However, the seeds for a “moral treatment” were planted during the Victorian Era, which has influenced mental health treatments today.
CLASS
Before the Asylum became the prominent facility for mental health treatment, lower class individuals with mental health issues, labeled “pauper lunatics” were primarily sent to workhouses–institutions that were dire and often deadly. This was especially true after the Poor Law of 1834 which limited outdoor relief for the impoverished, funneling all towards the workhouse. At this time, the rich would receive private home care or would stay in private luxury institutions. However, public asylums were built during the 19th century in order to house the burgeoning mentally ill. The upper classes still primarily were cared for as they had been earlier, privately. For the poor, workhouses were still a primary place of care; so long as individuals fell under the nomenclature of non-violent/dangerous lunatics, the workhouse was their fate. The “dangerous” pauper lunatic would be housed in public asylums. However, it did take involvement of the law to guarantee this; the Lunacy Amendment Act of 1862 required space to be held for pauper lunatics within Asylums. This Act also ended the practice of funneling the lower class mentally ill from asylums to workhouses as a method of dealing with overcrowdedness. However, the overcrowded environment of Asylums meant that many pauper mentally ill did not receive treatment and remained in the workhouse. At the same time, the impoverished were far more likely to be labeled as insane as a method of controlling the populations, thus sending them to the poor house.
GENDER
The Victoria era represented the first time that women were documented under the category of “insane” in greater numbers than men, despite the prevalence of the association of women and madness in popular folklore. The creation of public asylums, a massive expansion of care facilities, saw the confinement of more women than men. Though, it is interesting to note that men represented the majority still confined in private asylums. The majority of committed women were labeled as lunatics with “female issues”. Female hysteria was one such label that was rooted in deeply sexist rhetoric, as it was often attributed to independent or socially/sexually deviant women. Hormonal changes associated with the menstrual cycle were also evidence of madness, labeled “uterine derangement.” As a cure for these feminine maladies, clitoridectomies were often performed, to stymie the sexually incurred “madness”. It is also interesting to note that roughly 10% of admitted women experienced symptoms of postpartum depression. “Old Maid Mania”--or menopause– was another feminine malady, treated harshly by procedures such as vaginal leeches. Most of the women confined in asylums were also represented individuals without a safety net, and confinement was often seen as a way to control them.
RACE
In the colonies of the British empire, there were also asylums. In India, there were separate asylums for “natives”. However, the terms for admittance were reserved only for the most violent lunatics under the Asylums Act of 1858. Most of this motivation lay in preventing overcrowding. There was also thought, rooted in the racist pseudoscience of phrenology, that labeled Indians as a passive and “feeble” race and therefore, less likely to be violent even when exhibiting signs of madness. The native asylums received poorer food rations, a larger ratio of patient to staff. These discrepancies were also present within asylums in South Africa. However, here, Asylums served both black and white populations, though had internal segregation which often resulted in African patients being placed in accommodations for violent individuals. Racially based psychology really began to play a role in the 1880s, when there became an effort to cleanse treatment facilities, and when the marker of insanity and violence became innately tied to race.
SOURCES
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